Cymbalta is used for treating depression and generalized anxiety disorder. It is used for managing pain caused by fibromyalgia and diabetic peripheral neuropathy (DPNP). Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI). It works by restoring the balance of certain natural substances in the brain (serotonin and norepinephrine), which helps to improve certain mood problems.

INSTRUCTIONS

Use Cymbalta as directed by your doctor.

Take Cymbalta by mouth with or without food. Taking it with food may help to decrease the chance of nausea or stomach upset.

Swallow Cymbalta whole. Do not break, crush, or chew before swallowing. Do not open the capsule and sprinkle the contents on food or in liquid.

Take Cymbalta on a regular schedule to get the most benefit from it. Taking Cymbalta at the same time each day will help you remember to take it.

Continue to take Cymbalta even if you feel well. Do not miss any dose.

Do not suddenly stop taking Cymbalta without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, diarrhea, dizziness, confusion, headache, increased sweating, nausea, nightmare, ringing in the ears, seizures, trouble sleeping, unusual tiredness, or vomiting. You will be closely monitored when you start Cymbalta and whenever a change in dose is made.

If you miss a dose of Cymbalta, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Cymbalta.

STORAGE

Store Cymbalta at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Cymbalta out of the reach of children and away from pets.

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Active Ingredient:Duloxetine hydrochloride.

Do NOT use Cymbalta if:

you are allergic to any ingredient in Cymbalta

you have uncontrolled narrow-angle glaucoma

you have liver problems or severe kidney problems, or you are having dialysis

you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days

Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased

Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased

Cimetidine, medicines for high blood pressure, or quinolone antibiotics (eg, ciprofloxacin) because they may increase the risk of Cymbalta's side effects

Certain antiarrhythmics (eg, flecainide, propafenone), phenothiazines (eg, chlorpromazine, thioridazine), or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Cymbalta.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cymbalta may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

Cymbalta may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Cymbalta with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Cymbalta may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Cymbalta; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

Do not suddenly stop taking Cymbalta. Some conditions may become worse when the medicine is suddenly stopped or the dose of Cymbalta is decreased. Your dose may need to be slowly lowered to decrease the risk of side effects.

Children and teenagers who take Cymbalta may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it. Watch patients who take Cymbalta closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

Serotonin syndrome is a possibly fatal syndrome that can be caused by Cymbalta. Your risk may be greater if you take Cymbalta with certain other medicines (eg, MAOIs, SSRIs, "triptans"). Symptoms may include agitation; coma; confusion; excessive sweating; fast or irregular heartbeat; fever; hallucinations; nausea, vomiting, or diarrhea; tremor. Contact your doctor at once if you have any of these symptoms.

Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Cymbalta. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.

If your doctor tells you to stop taking Cymbalta, you will need to wait for at least 5 days before beginning to take certain other medicines (eg, MAOIs). Ask your doctor when you should start to take your new medicines after you have stopped taking Cymbalta.

Lab tests, including blood pressure and liver function, may be performed while you use Cymbalta. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Cymbalta with caution in the elderly; they may be more sensitive to its effects, especially low blood sodium levels.

Caution is advised when using Cymbalta in children; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.

Cymbalta should be used with extreme caution in children; safety and effectiveness in children have not been confirmed.

Pregnancy and breast-feeding: Cymbalta may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Cymbalta while you are pregnant. Cymbalta is found in breast milk. Do not breastfeed while taking Cymbalta.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome: